A recent clinical trial investigated the efficacy of oral antimicrobial prophylaxis as an adjunct to intravenous antibiotic prophylaxis in reducing SSIs after elective colorectal surgery.
Surgical site infections (SSIs) are a major complication of colorectal surgery that can lead to prolonged hospital stays, readmission, and even death. As such, prevention of SSIs is of utmost importance to ensure positive surgical outcomes.
The trial, conducted in 11 university and non-university hospitals in France between May 2016 and August 2019, enrolled 926 adults scheduled for elective colorectal surgery. Patients were randomly assigned to receive either a single 1 g dose of ornidazole (Number of patients=463) or placebo (Number of patients=463) orally 12 hours before surgery, in addition to intravenous antimicrobial prophylaxis before surgical incision.
The primary outcome of the trial was the proportion of patients with surgical site infection within 30 days after surgery. The trial also measured secondary outcomes, including individual types of surgical site infections and major postoperative complications within 30 days after surgery.
The results of the trial showed that the addition of a single 1 g dose of ornidazole significantly reduced surgical site infections among adults undergoing elective colorectal surgery. Specifically, surgical site infection within 30 days after surgery occurred in 13% of patients in the oral prophylaxis group compared to 22% in the placebo group. The proportion of patients with deep infections and organ space infections was also lower in the oral prophylaxis group. In addition, major postoperative complications occurred in a smaller proportion of patients in the oral prophylaxis group compared to the placebo group.